卒中诱导的免疫抑制和卒中相关性肺炎的研究进展

Progress in stroke-induced immunosuppression and stroke-associated pneumonia

近年来,卒中诱导的免疫抑制(SIDS)和卒中相关性感染(SAI)成为研究调查的点热,卒中后的炎症反应能促进组织愈合和清除坏死细胞,但过度的炎症反应可致继发性损害。SIDS不仅抑制炎症反应,降低其对脑组织的保护,还能降低机体对病原菌的抵抗力,增加感染的发生概率。近年来,卒中相关性感染是导致卒中患者死亡的主要原因,而且卒中相关的感染性并发症的发生与患者的预后有着密切的相关性,在这些感染性并发症中,肺炎是最常见类型。研究发现,卒中相关性肺炎(SAP)的发病率呈逐年增高的趋势,且SIDS和SAP密切相关。本文以免疫抑制为切入点,对SAP的机制、高危因素、预防和治疗等方面进行综述,为治疗SAP,提高卒中相关性肺炎患者的预后提供借鉴。

In recent years,stroke induced immunosuppression （SIDS） and stroke related infection （SAD have become the hot spot of research. Post stroke inflammatory reaction can promote tissue healing and remove necrotic cells, but excessive inflam matory reaction can cause secondary damage. SIDS not only inhibits the inflammatory response,reduces the protection of the brain tissue,but also reduces the body＇s resistance to the pathogenic bacteria and increases the incidence of infection. In recent years, stroke related infection is the main cause of death in stroke patients,and the occurrence of stroke related infectious complications is closely related to the prognosis of patients. Pneumonia is the most common type among these infectious complications. It is found that the incidence of SAP is increasing year by year,and SIDS and SAP are closely related. In this paper,we take immunosuppres sion as the entry point, and summarize the mechanism, risk factors, prevention and treatment of SAP, and provide reference for the treatment of SAP and improve the prognosis of patients with stroke related pneumonia.